Lung adenocarcinoma (LUAD) has a heterogeneous prognosis and controversial postoperative treatment protocols. We aim to develop and validate a multimodal analysis framework that integrates CT images with H&E-stained whole-slide images (WSIs) to enhance risk stratification and predict adjuvant chemotherapy benefit in LUAD patients. We retrospectively collected data from 1039 resectable LUAD patients (stage I-III) across four centres, forming a training dataset (n = 303), two testing datasets (n = 197 and n = 228) for survival analysis, and a feature testing dataset (n = 311) for interpretability analysis.
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